scholarly journals Parent-Infant Interaction during the First Year of Life in Infants at High Risk for Cerebral Palsy: A Systematic Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-19 ◽  
Author(s):  
F. Festante ◽  
C. Antonelli ◽  
O. Chorna ◽  
G. Corsi ◽  
A. Guzzetta
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Family Involvement ◽  
Developmental Trajectories ◽  
Cochrane Library ◽  
High Risk Infant ◽  
Neurological Risk ◽  
Interactive Behaviors ◽  
Early Parent ◽  
High Level

Introduction. Perinatal adverse events put neonates at high risk for short and long-term disabilities, including cerebral palsy (CP). The most recent guidelines about early intervention in infants with brain damage have emphasized the importance of family involvement from the very first phases of development. Early parent-infant interactions are pivotal in promoting infant cognitive and social developmental trajectories. However, little is known about the extent to which severe adverse perinatal events can affect the quality of early parent-infant interactions. Patients and Methods. We systematically searched five databases (PubMed, PsycINFO, EMBASE, CINAHL, and Cochrane Library) for the publications assessing parent-infant interactions in infants at high neurological risk within 1 year of age. Articles were selected if they involved direct comparison between high-risk populations and healthy controls or low-risk populations, and if quantitative or semiquantitative tools were used to assess the parent-infant interaction. Measures of parent-infant interaction included infant interactive behaviors, parental interactive behaviors, and dyadic interactive patterns. Results. The search yielded 18 publications that met the inclusion criteria. The articles represent a high level of heterogeneity in terms of infant neurological risk, infant age, and tools assessing interactive behaviors. Both infant and maternal behaviors within the investigated interactive exchanges were reported to be compromised, leading to subsequent overall impairment of the dyadic patterns. Conclusion. While the studies reviewed here provide general and important information, the review did not yield a clear picture of early dyadic interactions in high-risk infant populations. Further observational studies are warranted in order to provide a more accurate knowledge of the early dyadic exchanges between infants at high neurological risk and their parents, as they might provide a critical opportunity for early family centered habilitative interventions.

scholarly journals Effectiveness of Treadmill Training on Walking Ability in Adults with Cerebral Palsy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (4) ◽  
pp. 34
Author(s):  
Nikolaos Chrysagis ◽  
Georgios Theotokatos ◽  
Emmanouil Skordilis ◽  
Vasiliki Sakellari ◽  
Eirini Grammatopoulou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
High Risk ◽  
Meta Analysis ◽  
Term Treatment ◽  
Risk Of Bias ◽  
Treadmill Training ◽  
Cochrane Library ◽  
Walking Ability ◽  
Long Term Treatment

Background: Patients with cerebral palsy (CP) may necessitate long-term treatment and monitoring of their condition, not only during the period of development but also during adulthood. Objectives: This systematic review aimed to analyze evidence from randomized controlled trials (RCTs) that have investigated the effect of treadmill training on walking ability in adults with cerebral palsy. Methods: RCTs were identified and selected systematically, with appropriate keywords applied in four scientific databases (Medline, Scopus, the Cochrane Library, and the Physiotherapy Evidence Database) and one bibliographic search engine (Google Scholar) from January 1980 to September 2021. Two assessors extracted and analyzed data from relevant RCTs published in English and then independently rated those studies for risk of bias with the Risk of Bias (RoB 2) tool. Results: Out of the 96 studies that were initially identified, 93 were excluded, as these either did not meet the inclusion criteria or were duplicates. Three clinical trials were finally included, characterized by some concerns and a high risk of bias (RoB 2). Meta-analysis was only performed for the maximum distance in the ‘6-minute walk for distance test’, due to differences in the remaining outcomes utilized between studies. Overall, there was evidence of some concerns and high risk of bias that treadmill training did not significantly improve the walking ability in adult patients with CP relative to the control conditions. Conclusion: More high-quality RCTs are required, examining the effectiveness of treadmill training on different aspects of walking ability such as gait speed, endurance, and energy expenditure.

A Systematic Review of Assessments and Interventions for Chronic Pain in Young Children With or at High Risk for Cerebral Palsy

2021 ◽  
pp. 088307382199691
Author(s):  
Lisa Letzkus ◽  
Darcy Fehlings ◽  
Lauren Ayala ◽  
Rachel Byrne ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Cerebral Palsy ◽  
High Risk ◽  
Online Survey ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Parent Report ◽  
Medical Cannabis ◽  
Nonpharmacologic Intervention

Background: Pain is common in children with cerebral palsy. The purpose of this systematic review was to evaluate the evidence regarding assessments and interventions for chronic pain in children aged ≤2 years with or at high risk for cerebral palsy. Methods: A comprehensive literature search was performed. Included articles were screened using PRISMA guidelines and quality of evidence was reviewed using best-evidence tools by independent reviewers. Using social media channels, an online survey was conducted to elicit parent preferences. Results: Six articles met criteria. Parent perception was an assessment option. Three pharmacologic interventions (gabapentin, medical cannabis, botulinum toxin type A) and 1 nonpharmacologic intervention were identified. Parent survey report parent-comfort and other nonpharmacologic interventions ranked as most preferable. Conclusion: A conditional GRADE recommendation was in favor of parent report for pain assessment. Clinical trials are sorely needed because of the lack of evidence for safety and efficacy of pharmacologic interventions.

The High-Risk Infant

1975 ◽  
Vol 55 (10) ◽  
pp. 1092-1096 ◽  
Author(s):  
Karen Goldberg
Keyword(s):  
High Risk ◽  
High Risk Infant

Resolving driver events in MLL-r negative high-risk infant ALL.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10030-10030
Author(s):  
Jennifer Seelisch ◽  
Matthew Zatzman ◽  
Federico Comitani ◽  
Fabio Fuligni ◽  
Ledia Brunga ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cell ◽  
High Risk ◽  
B Cell ◽  
Gene Expression Profiling ◽  
Rna Sequencing ◽  
Clinical Features ◽  
Expression Profiling ◽  
High Risk Infant ◽  
Childhood All

10030 Background: Infant acute lymphoblastic leukemia (ALL) is the only subtype of childhood ALL whose outcome has not improved over the past two decades. The most important prognosticator is the presence of rearrangements in the Mixed Lineage Leukemia gene (MLL-r), however, many patients present with high-risk clinical features but without MLL-r. We recently identified two cases of infant ALL with high-risk clinical features resembling MLL-r, but were negative for MLL-r by conventional diagnostics. RNA sequencing revealed a partial tandem duplication in MLL (MLL-PTD). We thus aimed to determine if MLL-PTD, other MLL abnormalities, or other genetic or transcriptomic features were driving this subset of high-risk infant ALL without MLL-r. Methods: We obtained 19 banked patient samples from the Children’s Oncology Group (COG) infant ALL trial (AALL0631) from MLL wildtype patients as determined by FISH and cytogenetics. Utilizing deep RNA-sequencing, we manually inspected the MLL gene for MLL-PTD, while also performing automated fusion detection and gene expression profiling in search of defining features of these tumors. Results: 3 additional MLL-PTDs were identified, all in patients with infant T-cell ALL, whereas both index cases were in patients with infant B-cell ALL. Gene expression profiling analysis revealed that all five MLL-PTD infants clustered together. Eight infants (7 with B-cell ALL) were found to have Ph-like expression. Five of these 8 infants were also found to have an IKZF1/JAK2 expression profile; one of these five had a PAX5-JAK2 fusion detected. Two infants (including the one noted above) had novel PAX5 fusions, known drivers of B-cell leukemia. Additional detected fusions included TCF3-PBX1 and TCF4-ZNF384. Conclusions: MLL-PTDs were found in both B- and T-cell infant ALL. Though Ph-like ALL has been described in adolescents and young adults, we found a substantial frequency of Ph-like expression among MLL-WT infants. Further characterization of these infants is ongoing. If replicated in other infant cohorts, these two findings may help explain the poor prognosis of MLL-WT ALL when compared to children with standard risk ALL, and offer the possibility of targeted therapy for select infants.

scholarly journals Driving and visual deficits in stroke patients

2018 ◽  
Vol 76 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Marina Marcondes Braga ◽  
Renato Nickel ◽  
Marcos Lange ◽  
Élcio Juliato Piovesan
Keyword(s):  
High Risk ◽  
Visual Attention ◽  
Visual Processing ◽  
Moderate Risk ◽  
Interference Factor ◽  
Visual Deficits ◽  
Useful Field Of View ◽  
High Level ◽  
Safe Performance ◽  
Intention Group

ABSTRACT Objective: The aim of the present study was to conduct an exploratory assessment of visual impairment following stroke, and to discuss the possibilities of reintroducing patients to the activity of driving. Methods: The Useful Field of View test was used to assess visual processing and visual attention. Results: A total of 18 patients were included in the study, and were assigned to either the drive group (n = 9) or the intention group (n = 9). In the drive group, one patient was categorized as moderate-to-high risk; whereas, in the intention group, one patient was categorized as low-to-moderate risk. Additionally, two patients in the intention group were categorized as high risk. The patients did not perceive their visual deficits as a limitation. Conclusion: Visual attention is an interference factor in terms of the safe performance of driving after a stroke. All patients showed a high level of interest for the independence provided through being able to drive.

scholarly journals High Risk of Suicide in Behavioral Variant Frontotemporal Dementia

2018 ◽  
Vol 34 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Milena Zucca ◽  
Elisa Rubino ◽  
Alessandro Vacca ◽  
Flora Govone ◽  
Annalisa Gai ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
High Risk ◽  
Frontotemporal Dementia ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Disease Duration ◽  
Suicide Ideation ◽  
Behavioral Variant Frontotemporal Dementia ◽  
High Level ◽  
Anxiety Depression

Aim: The purpose of the study was to determine the prevalence of suicidal ideation and attempts in patients with behavioral variant frontotemporal dementia (bvFTD), evaluating possible risk factors for suicidality. Methods: Risk of suicide was assessed using the Scale for Suicide Ideation (SSI) in 35 patients with bvFTD and 25 controls. Results: According to SSI, 40% of patients with bvFTD had suicidal ideation in comparison to 8% of controls ( P = .009). Four patients with bvFTD have attempted suicide versus none control ( P = .006). Patients with bvFTD with suicide risk showed higher levels of anxiety, depression, stress, and hopelessness than patients without suicide risk ( P < .001). Patients who attempted suicide were younger and had a longer disease duration than those with only suicide ideation. Intriguingly, 40% of patients with parkinsonism presented high level of suicide ideation. Conclusions: Our findings show that patients with bvFTD have a high risk of suicide. Additional studies in larger populations are needed to confirm our results.

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